hatzinikolaou & murray (2010). infant sensitivity to negative maternal emotional shifts: effects of...

A R T I C L E

INFANT SENSITIVITY TO NEGATIVE MATERNAL

EMOTIONAL SHIFTS: EFFECTS OF INFANT SEX, MATERNAL

POSTNATAL DEPRESSION, AND INTERACTIVE STYLE

KORNILIA HATZINIKOLAOUInstitute of Child Health, Athens, Greece

LYNNE MURRAYUniversity of Reading, UK

ABSTRACT: This study examined the effects of infant sex, maternal postnatal depression, and maternalinteractive style on infant sensitivity to maternal negative emotional shifts. Face-to-face interactions of68 motherinfant dyads were analyzed at 8 and 18 weeks. Twenty-five (28%) mothers had postnataldepression. Interactions were analyzed in terms of overall maternal interactive style: sensitive, anxious,intrusive, and sad. Episodes of negative shifts in maternal emotional expression were recorded, alongwith expressions of infant sensitivity to these changes. Daughters of depressed mothers showed higherrates of sensitivity to maternal negative emotion whereas their sons showed lower rates, in comparison toboth girl and boy infants of well mothers. While maternal interactive style had no effect on 8-week infantsensitivity to maternal negative emotional shifts, high rates of 18-week infant sensitivity were predicted byboth an 8-week and a concurrent, sad maternal interactive style. The findings are discussed in relation totheories of emotional and interpersonal development.

RESUMEN: Este estudio examino los efectos que el sexo del infante, la depresion maternal postnatal, yel estilo interactivo de la madre tienen sobre la sensibilidad del infante hacia los cambios emocionalesnegativos de la madre. Se analizaron las interacciones cara a cara de 68 madre-infante dadas a las 8 y18 semanas del infante. Veinticinco (28%) madres sufran de depresion postnatal. Las interacciones fueronanalizadas en funcion del estilo interactivo general de la madre, sensible, ansiosa, entremetida, ytriste. Se tomo nota de los episodios de cambios negativos en la expresion emocional de la madre, ascomo tambien de las expresiones de sensibilidad del infante hacia tales cambios. Las hijas de madresdepresivas mostraron puntajes mas altos de sensibilidad a la emocion negativa de la madre, mientras quelos varones mostraron puntajes mas bajos, en comparacion a las ninas y varones de madres en buenascondiciones. Mientras que el estilo interactivo maternal no tuvo ningun efecto en la sensibilidad que losinfantes de 8 semanas mostraban hacia los cambios emocionales negativos de la madre, se predijeron altospuntajes de la sensibilidad del infante a las 18 semanas, por medio de un estilo interactivo maternal triste

The research was funded by the MRC (United Kingdom) and the Alexander S. Onassis Public Benefit Foundation.We thank Liz McGregor and Liz Schofield for assistance with recruitment and data collection, and Carla Martinsfor assistance with data coding. We also thank anonymous reviewers for their comments on a previous versionof this article.Direct correspondence to: Lynne Murray, Winnicott Research Unit, School of Psychology, University of Reading,Reading, United Kingdom RG6 6AL; e-mail: [email protected].

INFANT MENTAL HEALTH JOURNAL, Vol. 31(5), 591610 (2010)C 2010 Michigan Association for Infant Mental HealthView this article online at wileyonlinelibrary.com.DOI: 10.1002/imhj.20265

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592 K. Hatzinikolaou and L. Murray

tanto a las 8 semanas como uno concurrente. Se discuten los resultados en relacion con las teoras deldesarrollo emocional e interpersonal.

R ESUM E: Cette etude a examine les effets du sexe du nourrisson, de la depression postnatale maternelle etdu style interactif maternel sur la sensibilite du nourrisson aux changements emotionnels negatifs maternels.Les interactions face-a`-face de 68 dyades me`re-nourrisson ont ete analysees a` 8 et 18 semaines. Vingt-cinq(28%) me`res etaient atteintes de depression postnatale. Les interactions ont ete analysees en termes destyle interactif maternel general, sensible, anxieux, intrusif et triste. Des episodes de changementsnegatifs dans lexpression de sensibilite du bebe a` ces changements. Les filles de me`res deprimees ontfait preuve de taux plus eleves de sensibilite a` lemotion maternelle negative, alors que leurs fils ont faitpreuve de taux plus bas, compare a` a` la fois les bebes filles et garcons de me`res netant pas deprimees.Alors que le style interactif maternel navait pas deffet sur la sensibilite aux changements emotionnelsnegatifs maternels du nourrisson de 8 semaines, des taux eleves de sensibilite du nourrisson de 18 semainesetaient predits par a` la fois un style interactif maternel triste, simultane et a` 8 semaines. Les resultats sontdiscutes en relation aux theories du developpement emotionnel et interpersonnel.

ZUSAMMENFASSUNG: Die Studie untersuchte die Auswirkungen von kindlichem Geschlecht, mutterlichenpostnatalen Depressionen und der Art und Weise, wie Mutter auf die Empfindlichkeit der Sauglingegegenuber ihren negativen emotionalen Schuben reagierten. Face-to-face Interaktionen von 68 Mutter-Kind Dyaden wurden mit 8 und 18 Wochen analysiert. Funfundzwanzig (28%) Mutter hatten postnataleDepressionen. Die Interaktionen wurden in Bezug auf den gesamten mutterlichen interaktiven Stil je insensibel, angstlich, aufdringlich und traurig eingeteilt. Episoden von negativen Veranderungenim mutterlichen, emotionalen Ausdruck wurden zusammen mit dem kindlichen Ausdruck von Empfind-lichkeit auf die Anderungen der Mutter aufgenommen. Die Madchen depressiver Mutter zeigten einehohere Empfindlichkeit gegenuber mutterlichen negativen Emotion, wahrend die Jungs niedrigere Grade,im Vergleich Jungen-Madchen der Sauglinge von gesunden Muttern, zeigten. Wahrend der mutterliche,interaktiven Stil keinen Einfluss die Empfindlichkeit der 8-Wochen-Saugling bei mutterlichen negativenemotionalen Schuben hatte, zeigte sich ein Zusammenhang von hohe Raten bei 18-wochigen Sauglingen,wenn gleichzeitige der mutterlichen interaktiven Stil traurig vorlag. Die Ergebnisse werden in Bezug aufdie Theorien von emotionaler und zwischenmenschlicher Entwicklungen diskutiert.

* * *

Infant Mental Health Journal DOI 10.1002/imhj. Published on behalf of the Michigan Association for Infant Mental Health.

Infant Sensitivity to Negative Maternal Emotional Shifts 593

Sensitivity to others emotions is considered a core aspect of satisfactory interpersonalrelations throughout life, and its development is assumed to start early in infancy (Stern, 2000;Trevarthen, 1993; Tronick, 1989). Indeed, research conducted over the past three decades hasshown young infants to be capable of engaging in face-to-face intersubjective communication,sharing their own intentions and emotions with others, and responding to the expression ofothers intentions and emotions (for a review, see Trevarthen, 2001). Nevertheless, the develop-mental course of infant emotional sensitivity and the influences on individual differences in itsexpression require further investigation. The current study addresses these issues; since studieswith older children have suggested that child sex, parenting style, and parental psychopathology,including maternal depression, are potentially important influences on child social and emo-tional development, we examined the role of these factors in the expression of infant emotionalsensitivity, conducting observations of face-to-face interactions in the first 5 months in depressedand nondepressed motherinfant dyads.

PREVIOUS RESEARCH

The question of how parenting might influence the development of emotional sensitivity hasnot previously been directly addressed in relation to early infancy; nevertheless, research on theeffects of experimentally perturbed adult communication and that on motherinfant interactionsin the context of maternal postnatal depression is highly relevant. Among the experimentalperturbation studies, those using the still-face procedure (Tronick, Als, Adamson, Wise, &Brazelton, 1978) and those where the contingency of maternal responses is disrupted (Murray &Trevarthen, 1985; Nadel, Carchon, Kervella, Marcelli, & Reserbat-Plantey, 1999) offer particu-larly clear examples of the infants sensitivity to how people relate to them in a dyadic context.Infant responses to the still-face phenomenon, comprising, for example, protest, distress, andavoidance, have been considered particularly clear evidence of infants affective attunement totheir social partners (Stern, 2000; Tronick, 2007) and of early social expectations (e.g., Muir &Hains, 1993).

With regard to maternal postnatal depression, the impact of the disorder on general featuresof motherinfant interactions and on a range of child outcomes has been widely studied (fora review, see Murray, Halligan, & Cooper, 2009). In general, depressed mothers are likely toexperience difficulties in their interactions with their infants, typically being less sensitive andresponsive than are well mothers (e.g., Cohn, Matias, Tronick, Connell, & Lyons-Ruth, 1986;Field, Healy, Goldstein, & Guthertz, 1990; Field, Healy, Goldstein, Perry, & Bendell, 1988;Murray, Fiori-Cowley, Hooper, & Cooper, 1996). Such impaired interaction styles have beenfound to affect infant emotional and behavioral regulation, including increases in infant negativeaffect, disturbances in attention, and less efficient processing of contingent relationships (Beebeet al., 2008; Stanley, Murray, & Stein, 2004; Tronick, 1989). In turn, such maternal interactiondifficulties have been found to predict poorer child cognitive and emotional functioning (e.g.,Milgrom, Westley, & Gemmill, 2004; Morrell & Murray, 2003; Murray, Kempton, Woolgar, &Hooper, 1993).

Note that depressed mothers do not form a homogeneous population. In high-risk samples,quite marked interactive difficulties can occur when mothers may be primarily intrusive andhostile or withdrawn and disengaged from the infant (e.g., Field et al., 1990; Y. Hoffman &Drotar, 1991; Jones, Field, Fox, Davalos, Malphurs, Carraway, Schanberg, & Kuhn, 1997).



Although low-risk depressed mothers might not show such extremes of impaired parenting,they may nevertheless display more subtle deficits as, for example, decreased sensitivity to theinfants responses and selective attention to infant negative affect (Murray et al., 1996). AsTronick and Weinberg (1997) suggested, the effects of maternal depression on the infant inlarge measure depend on the predominant interactive style of the depressed mother. Thus, forexample, withdrawn mothers fail to contribute to the regulation of early interactions with theirinfants because of their low levels of energy and impaired ability to respond to infant needsand emotions while the failure of intrusive mothers consists of their constantly disrupting theinfants experience. Although findings have not always been consistent (Rutter, 1990), evidencehas suggested that infants of depressed mothers who have an intrusive interactive style are morelikely to show an avoidant response to cope with interactive stress, while infants of depressedmothers who are withdrawn are more likely to protest and become distressed (Cohn et al., 1986;Tronick, 1989).

While the findings outlined earlier concerning infant responsiveness to broad differences indepressed mothers interactive style are informative, research also has suggested that it may beparticularly productive to study the development of infant emotional sensitivity in the specificcontext of maternal expressions of negative emotion (Field, 1984; Field et al., 1990; Murray et al.,1996). For example, in their study of postnatally depressed mothers and their infants, Murrayet al. (1996) showed, in second-by-second analyses of motherinfant responses, that episodeswhen infant behavior became dysregulated, or disrupted, were likely to have been immediatelypreceded by the expression of maternal negativity. Furthermore, studies of sensitivity to negativeemotion in older children of depressed mothers also have indicated the importance of takingthe childs sex into account. Thus, although studies of well mothers children have shown sexdifferences in sensitivity, as assessed by empathic behavior, to be either small or absent (e.g.,Miller, Eisenberg, Fabes, & Shell, 1996; Radke-Yarrow & Zahn-Waxler, 1976; Zahn-Waxler& Radke-Yarrow, 1982), the great majority of studies of depressed-mothers children haveshown more sensitivity in females than in males (Murray, Woolgar, Briers, & Hipwell, 1999;Radke-Yarrow, Zahn-Waxler, Richardson, Susman, & Martinez, 1994; Zahn-Waxler, Kochanska,Krupnick, & McKnew, 1990; Zahn-Waxler, Radke-Yarrow, Wagner, & Chapman, 1992; but seeFrankel, Lindahl, & Harmon, 1992). While these findings are in line with some studies ofinfant responses to the still-face procedure, where girls became more negative or stressed thandid boys (Mayes & Carter, 1990; Stoller & Field, 1982; Toda & Fogel, 1993), others havefound boys to show more poorly regulated responses (Weinberg, Olson, Beeghly, & Tronick,2006; Weinberg, Tronick, Cohn, & Olson, 1999). Such inconsistent findings require furtherclarification; furthermore, the question of whether there are sex differences in infant sensitivityto negative maternal emotions during naturally occurring face-to-face social interactions has yetto be addressed.

THE CURRENT STUDY

While the studies outlined earlier concerning emotional sensitivity have considered its devel-opment from early childhood and have sought to identify factors that might be associated withit, this issue has not been sufficiently investigated in early infancy. We aimed to address thisquestion in the current study. Thus, we examined 8- and 18-week-old infants sensitivity tomaternal emotions and explored the roles of maternal postnatal depression, mothers overall



interactive style, and infant sex. Given the suggestion that human emotional sensitivity is morelikely to be observed in instances where there is an expression of negative, rather than positive,emotions in others (e.g., L.M. Hoffman, 2000; Wispe, 1991), we focused on infant responses tothe maternal expression of negative emotions. In particular, since some studies have noted theimpact on the infant of shifts from positive to negative maternal behavior (e.g., Murray et al.,1996; Murray & Trevarthen, 1985; Nadel et al., 1999), we studied indices of infant emotionalsensitivity in instances where there was a negative shift in maternal emotional expression.

In examining the relationship between infant sensitivity to negative maternal emotion andoverall maternal interactive style, we combined two levels of coding: microanalysis for theformer, and more general, global ratings for the latter. With regard to microanalysis, we adoptedan approach consistent with our own earlier work (Murray et al., 1996) and that of a numberof other researchers (e.g., Cohn & Tronick, 1988; Weinberg & Tronick, 1994), who haveapplied such coding to specified behaviors within the overall interaction to address particular,clinically important issues; this approach contrasts with more usual microanalytic proceduresemploying, for example, time-series analysis of contingency, where an entire interaction sessionis microanalytically coded (e.g., Stanley et al., 2004). By combining a microanalytical approachfocused on specific events of interestin this case, infant responses to discrete episodes ofnegative maternal emotional shifts, with real-time global coding of the motherinfant interaction,it becomes possible to obtain descriptions of the wider context in which microanalyticallyanalyzed events of interest take place.

METHOD

Sample

Primiparous women attending the routine 20-week antenatal clinic at the Royal Berkshire Mater-nity Hospital, Reading, United Kingdom were approached for recruitment into a study of infantemotional development. Reading has a population of around 140,000, and its demographics arerepresentative of the U.K. population as a whole. Mothers were asked to complete a short ques-tionnaire, the Predictive Index (Cooper, Murray, Hooper, & West, 1996), giving demographicdetails and information on factors related to the occurrence of postnatal depression. A stratifiedsampling procedure was used to increase, over the usual base rate of around 10%, the numbersof postnatally depressed mothers who were recruited; thus, all those with high scores (>27) onthe Predictive Index were approached, of whom 1 in 3 would be expected to become depressed(Cooper et al., 1996), as well as a random sample of those with medium to low scores. Thesemothers were contacted again after delivery. At this point, women whose gestation had been lessthan 37 weeks or more than 42 weeks or who were planning to move away from the Readingarea in the near future were excluded from the study. Additionally, only healthy infants, witha birth weight of at least 2.5 kg and with no serious perinatal problems, were included. Ninetymothers and their infants were recruited. The mean age of mothers was 27.6 years (SD = 5.8);almost all were White (98%) and were either married or cohabiting (94%); 18% had completeduniversity-level education.

Procedure

Motherinfant interactions were observed in research rooms at the University of Reading at 8and 18 weeks. The researcher helped the mother and the infant to become familiarized with the



observation room. When the infant appeared alert and contented, she or he was positioned in acomfortable infant seat placed adjacent to a front-surfaced mirror. The mother sat opposite theinfant to permit face-to-face engagement. A video camera was positioned in such a way that itrecorded both the mother, through her reflection in the mirror, and the infants face and torso.The video recording of the motherinfant face-to-face interaction lasted 5 min. This time framewas based on our own previous work (e.g., Murray et al., 1996) and inspection of a sample ofour earlier material which showed that this time frame was required for reliable observation ofinfant sensitivity.

The instructions given to the mother were to play with her infant, without using toys, asshe might usually do at home. The researcher left the mother and infant alone in the room. Therecording was stopped if the infant became inconsolably distressed.

At 8 weeks following the motherinfant interaction, mothers completed a questionnaireconcerning their experience of depression.

Measures

Motherinfant interactions. The video recordings of motherinfant interactions at 8 and18 weeks were analyzed using event and time-sampled coding schemes. For each maternaland infant behavior, one coder who was blind to all other information scored videotapes for thefull sample. A random subsample of tapes for 12 (13%) mothers and infants were also scoredby a second independent researcher.

Maternal behavior.

Time sampled coding. To characterize mothers general interactive style, each 30 s ofmaternal behavior with the infant was scored using an extended version (Hatzinikolaou, 2002)of the Global Ratings Scales (GRS) for motherinfant interactions, originally devised by Murrayet al. (1996). The original GRS comprise nine 5-point scales characterizing maternal behavioron three dimensions: sensitivity, intrusiveness, and remoteness. The overall sensitivity scale isbased on Ainsworth, Blehar, Waters, and Walls (1978) conceptualization of sensitivity (behaviorthat is responsive and well-attuned to the infant), and is formed by summing scores for scales ofwarmth, acceptance, nondemanding, responsive, and sensitive behavior. That for intrusivenesscombines ratings on scales concerning intrusive behavior (cutting across or interfering withthe infants behavior) and intrusive speech (relentless speech, failing to give the infant time torespond) while the dimension of remoteness combines those for maternal silence (long, awkwardpauses) and remote/self-absorbed behavior (distant posture, looking lost in her own thoughts).The GRS are of established reliability, and have been successfully used to identify differences ina wide range of maternal and infant populations (for a review, see Gunning et al., 2004). Sincethe principal focus of the current study was the infants sensitivity to maternal emotion, we usedthree further 5-point scales describing maternal behavior according to (a) the extent to which themother was emotionally expressive (using clear, frequent, and animated facial signals); (b) thedegree of her manifest anxiety (e.g., biting lip; hesitant, clipped speech; nervous laughter); and(c) her emotional state, from happy to unhappy (frequent smiles, warm vocalization vs. sad facialexpression, low pitch, and falling intonation contours). These additional scales were includedto provide a more comprehensive account of the emotional quality of the mothers interactivestyle, which could be then analyzed in relation to the infants sensitivity to moment-by-moment



changes in maternal emotional expression. The mean intraclass correlation for the two observersratings of the maternal scales for the present sample was .73 (range = .63.89).

Event sampled behaviors. Using the Observer 4.0 digital video analysis software, whichallows behavior to be scored with frame accuracy of 1/10 of a second, the initiation of allinstances of descending (i.e., shifts from more positive to more negative, and from positive tofalling flat) changes in maternal emotional expression as well as all instances of shifts fromone negative emotion to another (e.g., from sadness to anger, disapproval to worry, etc.) wererecorded. These were indexed by changes in maternal facial expressions (e.g., frown, sneer),tone of voice (e.g., falling intonation contour, harsh, tense vocalization), and gaze (e.g., cuttinggaze). Kappas for these behaviors were .72, .75, and .78, respectively. Coding of these maternalbehaviors was made to subsequently examine infant sensitivity to negative shifts in maternalemotion.

Infant behavior.Event-sampled infant sensitivity to negative emotional change. Having noted the time

points when negative changes in maternal emotional expression were initiated, the infant wasobserved; episodes of emotional sensitivity were scored as being present or absent within 3 sof the initiation of the maternal event, using a predefined set of behaviors. Infant behaviors in-dexing sensitivity were selected on the basis of pilot work and the literature on infant emotionalexpressions and responses during motherinfant interactions, including perturbed communica-tion (e.g., Muir & Hains, 1993; Murray & Trevarthen, 1985; Oster, Hegley, & Nagel, 1992;Tronick et al., 1978). The principal behavioral features identified from this preparatory work ascomprising an episode of sensitivity were as follows:

A change in facial expression of emotion to one of sadness (e.g., frown, cry face,pouting lower lip), concern, or apprehension (e.g., raised frown) (Murray & Trevarthen,1985; Peck, 2003; Yirmiya, Kasari, Sigman, & Mundy, 1990).

A change to a state of emotional attentiveness, involving a distinct stilling of infantbehavior, accompanied by a sober facial expression and fixed attention to the mothersface (e.g., Reddy, 2008).

A focusing of the gaze, involving, for example, a widening of the eyes and an increase inpupil size (Klaus, Kennell, & Klaus, 1995).

Interrater reliability for infant events was as follows: For the overall number of instances ofinfant-expressed sensitivity to maternal negative emotional shift, the intraclass correlation was.95; for individual occurrences, = .78. The number of instances of agreement concerning anepisode of infant sensitivity to maternal negative emotional shift, expressed as a percentage oftotal episodes identified by either coder, was 82%. Agreement for individual infant behavioralcategories was, for facial expression of emotion, = .69; for attention, .62; and for gaze, = .65.

Maternal depression. Maternal postnatal depression was assessed using the Edinburgh PostnatalDepression Scale (EPDS; Cox, Holden, & Sagovsky, 1987). This is a 10-item scale, developedto identify depressive symptoms in postpartum samples, with scores ranging from 0 to 30. Inline with other studies, a cutoff of EPDS scores equal or greater than 12 was used to identify



episodes of postnatal depression. The EPDS has been validated in similar community samplesand, at this threshold, has good sensitivity, specificity, and positive predictive value in relationto Research Diagnostic Criteria (Murray & Carothers, 1990). Using this criterion, 25 (28%)women were identified as experiencing postnatal depression.

RESULTS

Data Analytic Strategy

Before proceeding with the main analysis of infant sensitivity to maternal negative emotionalshifts, the global ratings of maternal behavior were examined to determine the nature of differentmaternal interactive styles and their relation to the occurrence of postnatal depression. Then,the occurrence of instances of infant sensitivity to negative emotional shifts in the motherwas examined, both for their frequency at each age and in relation to the mothers interactivestyle. The occurrence of infant sensitivity was also investigated in relation to maternal postnataldepression and the sex of the infant. Finally, we used regression analyses to examine the questionof the joint contributions of maternal depression, infant sex, and maternal interactive style toinfant sensitivity to negative emotional change in the mother.

Intragroup variability in terms of maternal interactive style at 8 and 18 weeks. The identificationof different styles of maternal interaction was achieved by means of k-means cluster analysis. Thiswas used because it does not assume membership of a specific group (e.g., postnatally depressedand well mothers) or the number of groups to be formed; rather, it allows classification intodifferent, nonoverlapping groups using individual scores on each of the variables examined.All maternal interactive characteristics scored using the GRS at each age were included in thek-means cluster analysis. Four clusters were identified at each age, all rating scales significantlydifferentiating between them. Thus, at each age, mothers could be characterized as being eithersensitive to the infant (high on sensitivity, low on unhappy scales) (36% at 8 weeks; 27.6% at18 weeks) or as showing one of three kinds of interaction difficulty: anxious (high manifestanxiety combined with low sensitivity ratings) (15% at 8 weeks; 8% at 18 weeks), intrusive(high levels of intrusive behavior, with lowmoderate sensitivity) (27.9% at 8 weeks; 21.8% at18 weeks), and finally, sad (high unhappy ratings, moderate sensitivity) (21% at 8 weeks; 42.5%at 18 weeks). The mothers interactive style showed continuity over time (McNemar changetest = .161, n.s.).

Maternal interactive style in relation to maternal mental state at 8 weeks. Investigation of theassociation between maternal interactive style and postnatal depression as measured by theEPDS showed, as predicted, that mothers who were postnatally depressed were less sensitiveto their infants than were other mothers at both 8 and 18 weeks, 2(1) = 2.716, p < .10, and2(1) = 4.051, p < .05, respectively. The occurrence of postnatal depression did not, however,distinguish between mothers showing the three different kinds of insensitivity at either age,2(3) = .201 n.s., and 2(3) = .162, n.s., at 8 and 18 weeks, respectively.

Instances of infant sensitivity to emotional change in the mother at 8 and 18 weeks. Of the 90motherinfant dyads observed, 22 (24.4%) were excluded from the analysis of infant sensitivityeither because of the infant was distressed, the mother was obscuring the view of her infantsface, or the video recording did not give a sufficiently clear view of the infants face for the



detailed analysis required. Thus, data on infant sensitivity were analyzed for 68 motherinfantdyads at both ages (75.6% of the sample). Of those dyads included in the analysis, 57 (83.8%)infants at 8 weeks and 54 (80%) infants at 18 weeks exhibited at least one instance of infantsensitivity to maternal negative emotional change during the 5-min face-to-face interaction.Rates were M = 5.1 (SD = 3.7, range = 019) and M = 4.7 (SD = 3.9, range = 019) at 8 and18 weeks, respectively. The distribution of instances of infant sensitivity at each age indicatedthe occurrence of outliers, with infants at each age showing 12 or more episodes. Analyses wereperformed both with and without outliers; since their exclusion did not change the pattern ofthe results, data for all 68 infants are presented. The number of instances of infant sensitivity tonegative emotional change in the mother at 8 weeks was significantly positively correlated withthe number of instances of infant sensitivity at 18 weeks (r = .49, p < .001).

Maternal interactive styles in relation to infant sensitivity. Before examining the relationshipbetween different maternal interactive styles and infant sensitivity, it was important to checkthat the rate of maternal negative emotional shifts (i.e., the context in which infant sensitivitywas observed) did not differ between the four maternal interaction groups, as any differencewould have confounded the interpretation of the occurrence of infant sensitivity. This check isparticularly pertinent to the question of whether infant sensitivity to maternal negative emotionis more likely to occur in the context of a sad maternal interactive style; in fact, comparisonsof the rates of maternal expressions of negative emotional shift between the sad interactivegroup and the other maternal interaction groups showed no differences at either age, F(1, 19) =.154, n.s., and F(1, 19) = .042, n.s., for 8- and 18-week comparisons, respectively. While thislast result may at first sight appear counterintuitive, note that even highly sensitive mothers mayshow downward shifts toward negative emotional expressions, as when, for example, they mirrorsome infant expression of discomfort; conversely, an insensitive, depressed mother may show achange toward a positive facial expression if, for example, she mocks the infant (Murray et al.,1996). Subsequently, one-way ANOVAs were used to determine whether there were effects ofmaternal interactive style on the number of instances of infant sensitivity at 8 and 18 weeks.

Eight-week maternal interactive style and infant sensitivity at 8 and 18 weeks. No asso-ciation was found between maternal interactive style at 8 weeks and concurrent expressions ofinfant sensitivity. By contrast, maternal interactive style at 8 weeks was significantly associatedwith the number of instances of infant sensitivity at 18 weeks, F(3, 64) = 4.735, p < .01 (seeFigure 1a). Post hoc tests revealed that 18-week-old infants of mothers who showed a sad in-teractive style at 8 weeks were significantly more sensitive to negative emotional shifts in themother than were infants of both sensitive (LSD: p < .01) and anxious mothers (LSD: p < .01),and infants of mothers who were intrusive at 8 weeks showed significantly more sensitivity at18 weeks than did infants of anxious mothers (LSD: p < .01).

Eighteen-week maternal interactive style and infant sensitivity at 18 weeks . Maternalinteractive style at 18 weeks was significantly associated with the occurrence of instances ofinfant sensitivity at 18 weeks, F(3, 66) = 10.161, p < .001. Post hoc tests showed that infants ofmothers presenting a sad interaction pattern at 18 weeks displayed significantly more sensitivityto negative maternal emotional shifts than did infants of sensitive (LSD: p < .01), intrusive(LSD: p < .01), and anxious (LSD: p < .05) mothers. The infants of 18-week intrusive, anxious,and sensitive mothers did not differ significantly from each other in the number of instances ofinfant sensitivity at 18 weeks (see Figure 1b).



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FIGURE 1. Ratings of maternal interactive style at 8 and 18 weeks in relation to instances of infant sensitivity at18 weeks.

Postnatal depression and infant sex in relation to infant sensitivity at 8 and 18 weeks. Two-wayANOVAs were used to examine effects of maternal EPDS-rated depression and infant sex, andtheir interaction on the number of instances of infant sensitivity at each age (see Figure 2).At 8 weeks, a significant effect of infant sex on sensitivity was found, F(1, 68) = 5.596, p

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